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If people were to achieve optimal cardiovascular health, there is potential to reduce about 80 to 90 percent of heart disease, according to Dr. Joanne Foody.

Health expert: Less than one percent of Americans have optimal cardiovascular health

by Megan Dawson
Apr 30, 2014


Dr. Joanne Foody

Dr. Joanne Foody is the Director of the Pollin Cardiovascular Wellness Center at Brigham and Women’s Hospital in Boston and a member of the medical advisory council of Sister to Sister

In the United States, one in four women die from heart disease – an ailment that is 80 to 90 percent preventable. Still, the death rates for heart disease in women are actually increasing. In fact, more women die of heart disease than cancer. Dr. Joanne Foody, the Director of the Pollin Cardiovascular Wellness Center at Brigham and Women’s Hospital in Boston, explains this grave phenomenon and tells women what they need to know to avoid succumbing to heart disease in this edited interview.

Why has heart disease surpassed cancer as the number one cause of death among women?

More women die each year of heart disease than all cancer deaths combined for women. And depending on the statistic, probably about 10 times more women die of heart disease than cancer.

We’ve been very good about systematically screening for cancers that affect women. Rates of mammography now are above 90 percent for women. The challenge is if we ask those same women if they know their blood pressure. It’s estimated only one in three women have had their blood pressure checked. There are really significant gaps in screenings for heart disease risk factors.

Unfortunately, women may go on for many decades as risk factors accumulate unbeknownst to them and unbeknownst to their health care provider until they are presented with chest pain, heart attack, stroke, or some consequence of those risk factors.

Is heart disease in women different from heart disease in men?

Some of the differences between heart disease in women is that women tend to be smaller, tend to have smaller arteries and tend to have a higher prevalence of small vessel disease, meaning they tend not to have blockages in their main coronary arteries to the same extent as men. Women, because of this, also tend to have more heart failure associated with heart disease.

Do women smoke to control their weight?

This is a huge issue. As much as smoking has declined in older individuals, we are seeing an uptick in smoking internationally in young women. The majority of the reason is in fact to control weight.

Women metabolize nicotine slightly differently than men and tend to get addicted quicker. It’s harder for them to quit smoking, and when women try to quit, they put on weight. So they have a negative reinforcement to keep smoking. For young women in particular, there’s a really deadly combination of smoking and oral contraceptive that can increase blood clots to the heart, brain and lungs – all of which can increase risk of death.

How does stress affect heart disease in women?

Any kind of stress, good stress, bad stress, emotional stress, increases the blood pressure and increases the heart rate, which creates more work for the heart. When people are stressed, they also tend to make worse health choices. They tend to eat less appropriately, lose sleep, and gain weight. All of these things conspire to increase your risk over time.

How preventable is heart disease?

If people were to achieve optimal cardiovascular health (be physically active, weigh the appropriate amount, eat the right food, have optimal blood pressure, optimal cholesterol, not smoke, not be diabetic) there’s potential to reduce about 80 to 90 percent of heart disease. The challenge, though, is that less than one percent of the U.S. is actually at optimal cardiovascular health. So, as much as we know it’s preventable, I think our lifestyle and society conspire against us because very few Americans have optimal cardiovascular health.

Under what circumstances should a woman be screened?

Everyone over the age of 18 should know their cholesterol, know their blood pressure and know whether or not they’re at risk for diabetes. If everything is perfect, those numbers should be reassessed at least every 5 years.

What’s really important is that women should know their numbers and know they’re not static. They should continually ask their health care provider: Should I get another cholesterol? Should I check my blood pressure? Should I be screened for heart disease or diabetes? Those questions should be asked at every visit, although they may not need those numbers checked every year depending on their age.

Where can women get screened?

There’s nothing particularly special about heart health screening other than the fact that they need to be done. These are things that can be done in a physician’s office, a clinic, and even in some of the pharmacy-based clinics as well as health fairs.

The key is that whatever or wherever a woman gets this checked, that first they get it checked, and second they follow up with their health care provider about the results. It’s no good to have a screening, wherever you may have it, if you don’t then take the next step to ensure that those numbers are the right numbers for you.